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Determinants of episiotomy in rural Zimbabwe
Janneke E van den Bergh1, Marieke Sueters, Marc Segaar
1Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
Background:
To assess the influence of parity, mode of birth, place of birth, a history of birth by only cesarean section and birthweight on episiotomy rates.
Methods:
Retrospective study of 3589 women giving birth vaginally from October 1997 to October 1998 in the Gutu district in Zimbabwe, to obtain the rate of episiotomy and its determinants.
Results:
The overall episiotomy rate was 27%; 54% in nulliparous and 6% in multiparous women. Perineal tears varied between 5 and 11% in the different places of birth.
Discussion:
An episiotomy rate of 54% in nulliparous women is higher than necessary. Medical and midwifery training should be adapted to facilitate a more restrictive use of episiotomy.